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DREF Operation N° MDRGH008 GLIDE N° EP-2013-000009-GHA 1 February, 2013

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DREF Operation N° MDRGH008 GLIDE N° EP-2013-000009-GHA 1 February, 2013 Disaster relief emergency fund (DREF) Ghana: Cholera Epidemic DREF operation n° MDRGH008 GLIDE n° EP-2013-000009-GHA 1 February, 2013 The International Federation of Red Cross and Red Crescent (IFRC) Disaster Relief Emergency Fund (DREF) is a source of un-earmarked money created by the Federation in 1985 to ensure that immediate financial support is available for Red Cross and Red Crescent emergency response. The DREF is a vital part of the International Federation’s disaster response system and increases the ability of National Societies to respond to disasters. CHF 205,309 has been allocated from the IFRC’s Disaster Relief Emergency Fund (DREF) to support Ghana Red Cross National Society (GRCS) in delivering immediate assistance to some 12,000 households. Unearmarked funds to repay DREF are encouraged. Summary: Ghana’s health authorities officially declared a cholera outbreak in the Ashanti region on 8th of January 2013. As of 21 January, 18 persons had died and over 250 persons are currently being cared for at the hospitals. Currently, 310 cases have been registered. The affected areas include the Obuasi Municipality District and Ejura/Sekyedumase District both in the Ashanti Region. These districts Hygiene awareness raising done by GRCS volunteers started reporting pockets of cholera cases in Photo: GRCS December 2012. With this DREF operation, GRCS intends to reduce the risks for spread of the cholera infection and assist infected persons through cholera prevention awareness activities targeting 12,000 households in the affected districts, and early detection of cases and referral services. Additionally, water, sanitation and hygiene promotion activities will be implemented in the affected communities in order to reduce risks for water borne diseases with focus on cholera. Furthermore, with support of the DREF, the GRCS and affected communities will have increased preparedness for rapid response and effective management to the current and future cholera outbreaks. This operation is expected to be implemented over three months, and will therefore be completed by 1 May 2013. A final report will be made available three months after the end of the operation ( by 1 August, 2013). <click here for the DREF budget; here for contact details; here to view the map of the affected area> The situation On the 8th of January, the Ghana Health Service (GHS) declared a cholera outbreak in the Ashanti region (Ashanti region health directorate). The most affected areas in the region include the Obuasi Municipality in the Obuasi District and Ejura Municipality in the Ejura/Sekyedumase District. These districts started reporting pockets of cases in December 2012. As of 21 January, 18 persons have died and over 250 persons are currently being cared for at the hospitals. Currently 310 cases have been registered. The majority of the infected persons are women (200 persons), and there is also a high number of children (53 persons) registered as being infected. Table over registered cholera cases 21/01/13 Number of Cases Number Number of Number Number affected of Males Females of Municipality of communities deceased children Obuasi 5 166 27 106 33 12 Ejura 5 144 30 94 20 06 Total 10 310 57 200 53 18 Source: Ghana Health Services The people living in Obuasi Township since their tap water supply was cut off, have, been depending on a river water source for their water consumption which is believed to have caused the cholera epidemic. Poor sanitation is also believed to have worsened the situation. In Ejura, poor sanitation and lack of a water source during the dry season has led to food contamination and diseases. The Ashanti Region is the third largest of 10 administrative Regions in Ghana, occupying 10.2 per cent of the total land area in the country (24,389 km²). About 47% of the populations are in the rural areas. All of the districts in the region have more than a quarter of households headed by females with the lowest (26.9%) in Ejura/Sekyedumase District, and the highest (40.1%) in the District of Ejisu-Juaben. Children constitute the greater proportion of household members in most of the districts. The estimated population in Obuasi municipal is around 200,000 persons while Ejura Sekyedumasi has an estimated population of around 114,000 (2010 Census). The usual movement patterns of people includes high mobility between communities due to personal and commercial reasons, which increases the risk for a rapid spread of the epidemic, should immediate measures not be taken. The GRCS intends to carry out social mobilization activities to complement the Government’s efforts in reducing morbidity and mortality due to this cholera outbreak. Coordination and partnerships The GRCS has become an important strategic partner to the Health Authorities in preventing diseases and epidemics, responding to health emergencies, and other health related programmes. The cooperation is facilitated through various health sector activities at national as well as district levels. The areas where GRCS in particular is providing support to the government includes health promotion, Community-Based Health and First Aid programmes (CBHFA), Integrated maternal and child health programmes, and HIV/AIDS programmes. GRCS is taking active part in the health coordination platform with the Ministry of Health (MoH), WHO, United Nation Children´s Fund (UNICEF) and other institutions. This platform is used for coordination of health interventions. A National Epidemic Coordinating Team (NECPT) coordinates and cascades interventions in the regions and districts. The NECPT is supervised by the Inter agency Coordinating Council (ICC), of which the GRCS is a member and lead agency for social mobilization during epidemics and neglected infectious diseases (NIDs). For this cholera outbreak the Government, through the MoH, will undertake training of community health nurses and disease control officers, surveillance, and vaccinations. UNICEF and WHO will provide capacity building to GHS. GRCS will complement the other actors with its community intervention on prevention Since 2010, GRCS has been actively involved in social mobilization for vaccination and for cholera prevention and response activities. The response has also included DREF operations (2012). The GRCS possibility for rapidly mobilizing volunteers for providing an immediate response to these kinds of outbreaks and spread of epidemics is crucial as a complement to government activities in the health facilities. Red Cross and Red Crescent action The GRCS, in collaboration with the Health Authorities, is planning to mobilize 80 volunteers (40 volunteers in each of the two municipalities) to support the social mobilization efforts of the Government. The 80 volunteers will be trained in Epidemic Control for Volunteers (ECV), Health and hygiene promotion and standard operational procedures (SOP) on disinfection of sanitary facilities. With the DREF support, the GRCS volunteers will conduct social mobilisation activities and cholera prevention sensitisation in the two affected municipalities. The volunteers will implement WatSan and hygiene promotion activities aiming to reduce the spread of the cholera infection and other waterborne diseases, through provision of water purification tablets, rehabilitating strategic water sources, and rehabilitating and disinfecting sanitary facilities in the affected communities. In addition, the preparedness of the two involved GRCS branches and affected communities will be strengthened in order to ensure a rapid response and effective management during current and future outbreaks. This will be achieved through setting up branch and community response structures, training of community volunteers and developing a response plan. The IFRC through its delegation in Abidjan in Cote D’Ivoire, will continue to work closely with the GRCS by supporting staff and volunteers in planning and implementation, and ensure that the operation is managed in an effective and efficient manner. A Regional Disaster Response Team (RDRT) staff with technical expertise in WatSan and health will be deployed for 2 months to provide technical assistance and support implementation of the DREF operation. Technical support from the logistic section of IFRC will be provided for procurement, transportation and distribution of items. IFRC will strengthen the capacity of the NS for reporting and monitoring of the operation, through provision of a computer, as well as technical support within this area. Furthermore, IFRC will monitor and evaluate the operation, and ensure that it is implemented with the principles and core values of the Red Cross movement to respond to the needs of the most vulnerable. The needs Within the two districts 310 persons are already infected, 18 persons have died, and more than 250 being attended to in hospitals. The majority of infected persons are women and children. A large part of the households in the affected districts are female headed households where the women often find themselves as the sole caretakers for families with many children. With the rapid spread of this infection, currently 10 communities are affected by the cholera outbreak and its population of 12,000 households (60,000 persons) are at high risk for getting infected. With lack of safe water and poor sanitary conditions the cholera infection could easily spread in these communities. There is also a heightened risk of spread of the epidemic to other areas, considering the mobility of people between communities and districts. With
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